Робин Кук - The Year of the Intern

Back in the elevator, I tried to remember when I had changed, but I could only recall scenes, possible small turning points, such as my first visit to the ward during medical school, and the eleven-year-old girl who lay on the bed looking hopefully up at us. She had cystic fibrosis, which is usually terminal. Listening to the house staff discuss the cases, I had melted, unable to look the youngster in the face. “Perhaps there’s a chance we can keep her alive until her late teens,” the attending physician had said as we walked away. At that instant I almost became a plumber.

The elevator door opened. Somehow, sometime, my responses had changed. Now I was worrying that someone would wake up in the morgue and ruin my image, make me look ridiculous. All right, I had changed, clearly for the worse, but what could I do about it?

Back in my room, the bed squeaked as it took my weight. In the semidarkness, my mind’s eye called up every detail of that skinny dead body. Did other interns brood like this? I couldn’t imagine it, but then, I couldn’t imagine what they would think. They seemed so self-possessed, so certain even when they had no right to be. Before med school, I had imagined an intern’s crisis in a different way, as somehow more noble. Always the problem had revolved around the loss of my own patient after a long struggle, the anguish of a life lost. But here I was sweating over whether someone else’s patient would start breathing again, and it bugged me that I could dismiss the person part. It was nine-forty-five. I rolled over, picked up the phone, and called the nurses’ quarters. At that moment I needed someone to be with, someone to prove that life went on. “Miss Stevens, please. Jan, can you come over? No, nothing’s wrong. Sure, bring the mangoes. That’s right, I’m on call.”

Through the curtains I could pick out a few stars. For two weeks I had been an intern, the longest two weeks of my twenty-five years, the culmination of everything, high school, college, medical school. How I had dreamed of it! Now nearly everybody I knew was in this blessed state of internship, and it was a crappy job, and when it wasn’t crappy it was a confusing mess. “Well, Peters, you’ve really done it now. I just want you to remember that it’s easy to drop out of the big leagues but almost impossible to get back in.” That is a direct quote from my surgery professor when he learned that I had decided to intern at a nonuniversity center, away from the ivory-tower medical circuit, out in the boondocks. And to the eastern medical establishment there is no boondock like Hawaii.

In terms of the immutable intern computer-matching system, I had been destined for any Ivy League internship. On that score, it was true enough that I had dropped out. But in the end I couldn’t help myself. As med school wore on I began to see that becoming a doctor meant giving yourself over to the system, like a piece of wood on a chipping machine. At the end of the machine I would be smooth and probably salable, full of knowledge. But as the chips flew away, so would those “nonproductive” personality traits — empathy, humanity, the instinct to care. I had to prevent that if I could, if it wasn’t too late. So at the last minute I had jumped off the machine. “Well, Peters, you’ve really done it now.”

Losing the skinny old man had me up tight, and I leaped off the bed even before Jan knocked. Thank God it wasn’t the phone. I was afraid of the phone. “Jan, it’s good to see you, mangoes and all.” Mangoes, just what I needed. “Sure, you can turn on the light. I was just sitting here thinking. All right, leave it off. Knives and a dish? You want to eat those mangoes now?” I didn’t want mangoes, but it wasn’t worth an argument, and, anyway, she looked delicious with the soft light shining on her hair, and she smelled as if she’d just stepped out of the shower, sweeter than any perfume. But the prettiest thing about Jan was her voice. Maybe she’d sing a little for me.

I got a dish and two knives, and we sat on the floor and started eating mangoes. At first, we didn’t talk, and that was one reason I liked her, for her reticence. She was good to look at, too, very much so, yet awfully young, I suspected. Before tonight we had gone out twice, yet we weren’t at all close. It didn’t matter. Well, it did matter, because I wanted to know her, especially right then. There was something poetic about her blond hair and small features; just then I needed us to be close.

The mango was sticky. I peeled the whole thing and went over to the sink to rinse my hands. When I turned back to her, she was facing away from me, and the light from the window was throwing areas of silver sheen on her hair. She was leaning on one arm, with her legs tucked along her other side. I almost asked her to sing “Try To Remember,” but I didn’t, probably because she would have — she did almost anything I asked in the way of song. If she started singing now, though, everybody in the quarters would hear it. In fact, they probably could hear us eating the mangoes. As I sat down next to her, she tilted her face and I could see her eyes.

“Something happened tonight,” I offered.

“I know,” she said.

That almost stopped me right there. I know. Like hell she knew, and I not only knew that she didn’t know, but also that I wasn’t going to be able to explain it to her. I went on anyway.

“I pronounced a skinny old man with cancer dead, and right now I’m afraid the phone will ring and it’ll be the nurse saying he’s alive after all.”

She tilted her head the other way, taking her eyes away. Then she really said the right thing. She said that was funny! Funny?

“Don’t you think if s crazy?”

Well, yes, it was crazy, but it was funny, too.

“You know that a person died tonight, and all I can think about is that he might still be alive and it’ll be a big joke. A big joke on me.”

She agreed that it would be a joke. That was the extent of her analysis on the subject. I persisted: “Don’t you think it’s strange for me to think such a stupid thing about the final event of somebody’s life?”

That was too much for her, I guess, because the next thing she said was to ask if I didn’t like mangoes. I like mangoes all right, but I didn’t want any just then; I even offered her some of mine. Despite the misfirings, I somehow felt better, as if trying to communicate my thoughts had removed the skinny old man from the front of my mind. I wondered if Jan would sing “Aquarius.” This girl made me feel happy in a simple way.

I put my arm around her, and she popped a piece of mango into my mouth, ludicrously throwing up a barrier without meaning to. So, okay, we won’t talk about my skinny old man, I thought. I kissed her, and when I realized she was kissing me back, I thought how nice it would be to make love with her. We kissed again, and she pressed against me, so I could feel her warmth and softness. My hands were still sticky from the mangoes, but I ran them up and down her back, wondering if she would make love. The thought chased everything else from my mind. It was ridiculous to be on the floor, and I was pondering how to get us both over to the bed when I realized she wasn’t wearing anything under her light dress — I had been too busy caressing her back to notice. She sensed my desire to move, and we stood up simultaneously. As I began to lift her dress, she stopped me, clasping my forearms, undid the back, and stepped out of it, so beautiful in the soft light. She might not have understood my problem, but she certainly had cleared my mind. That poetry I had thought about her enlarged to include her breasts. I peeled off my shirt, dropped the stethoscope on the floor, and moved to her quickly, afraid she might disappear.